Medication Treatment for Opioid Use Disorder in Expectant Mothers

NCT ID: NCT03918850

Last Updated: 2025-06-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-21

Study Completion Date

2025-01-31

Brief Summary

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The primary objective of this study is to evaluate the impact of treating opioid use disorder (OUD) in pregnant women with extended-release buprenorphine (BUP-XR), compared to sublingual buprenorphine (BUP-SL), on mother and infant outcomes. The primary hypothesis is that the BUP-XR group will not have greater illicit opioid use than the BUP-SL group during pregnancy (non-inferiority).

Detailed Description

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This is an intent-to-treat, two-arm, open-label, pragmatic randomized controlled trial. Eligible participants will be randomized in a 1:1 ratio to BUP-XR or BUP-SL, balancing on site, estimated gestational age (EGA) at time of randomization (6 weeks-18 weeks vs. 19 weeks-30 weeks), and whether they are on BUP-SL at the time of randomization (yes vs. no). Participants will be provided with study medication and attend weekly medication visits through 12 months postpartum.

Conditions

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Opioid-Related Disorders Drug Addiction Pregnancy Related Substance Abuse Drug Abuse Neonatal Abstinence Syndrome Neonatal Opioid Withdrawal Syndrome Drug Abuse in Pregnancy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is an intent-to-treat, two-arm, open-label, pragmatic randomized controlled trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

The primary outcome is assessed in a masked fashion by a central laboratory, but there is no masking for other outcomes.

Study Groups

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BUP-XR

Weekly subcutaneous Buprenorphine Injection (CAM2038) during pregnancy. During the 12-month postpartum phase, participants who are breastfeeding will continue receiving subcutaneous Buprenorphine Injection weekly; participants who are not breastfeeding will receive subcutaneous Buprenorphine Injection monthly.

The target doses will be 24 mg for the weekly formulation and 96 mg for the monthly formulation, but the actual dose may be lower or higher as determined by the prescribing clinician (e.g., based on craving/withdrawal experienced by the participant, etc.).

Group Type EXPERIMENTAL

Buprenorphine Injection

Intervention Type DRUG

Weekly and monthly formulations of injectable, extended-release buprenorphine (BUP-XR).

BUP-SL

Daily sublingual buprenorphine, with or without naloxone, based on site preference, during pregnancy and during the 12-month postpartum phase.

The target dose will be 16 mg daily, but the actual dose may be lower or higher as determined by the prescribing clinician (e.g., based on craving/withdrawal experienced by the participant, etc.).

Group Type ACTIVE_COMPARATOR

Buprenorphine Sublingual Product

Intervention Type DRUG

Sublingual buprenorphine (BUP-SL), administered daily.

Interventions

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Buprenorphine Injection

Weekly and monthly formulations of injectable, extended-release buprenorphine (BUP-XR).

Intervention Type DRUG

Buprenorphine Sublingual Product

Sublingual buprenorphine (BUP-SL), administered daily.

Intervention Type DRUG

Other Intervention Names

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CAM2038 Subutex Suboxone

Eligibility Criteria

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Inclusion Criteria

Potential participants must:

1. be 18-41 years of age
2. be pregnant with an estimated gestational age (EGA) of 6 - 30 weeks at randomization, has evidence of a viable intrauterine pregnancy if EGA \< 12 weeks and is not planning to terminate the pregnancy
3. have a single fetus pregnancy (can be based on self-report if an objective assessment is unavailable)
4. meet Diagnostic and Statistical Manual (DSM)-5 criteria for moderate/severe OUD and be a good candidate for BUP maintenance and/or be currently prescribed BUP for the treatment of OUD
5. be willing to be randomized to BUP-XR or BUP-SL and to comply with study procedures, including weekly Medication Check Visits
6. be planning to deliver at one of the hospitals for which the BORN survey was completed and that: a) has a written protocol for the management of neonatal abstinence syndrome (NAS) / neonatal withdrawal syndrome (NOWS), b) offers rooming-in while infants are being observed for NAS/NOWS; and c) does not send infants home on opioids for the treatment of NAS/NOWS
7. be enrolled in outpatient addiction treatment at a participating site (e.g., have completed intake)
8. be able to understand the study, and having understood, provide written informed consent in English

Exclusion Criteria

Potential participants must not:

1. have a physiological dependence on alcohol or sedatives requiring medical detoxification
2. have a psychiatric condition that, in the judgment of the site medical clinician (MC), would make study participation unsafe or which would make treatment compliance difficult. Examples include:

* Suicidal or homicidal ideation requiring immediate attention
* Severe, inadequately-treated mental health disorder (e.g., active psychosis, uncontrolled bipolar disorder)
3. have a medical condition that, in the judgment of the study MC, would make study participation unsafe or which would make treatment compliance difficult. Medical conditions that may compromise participant safety or study conduct include, but are not limited to, allergy/sensitivity to study medications and the following based on clinical labs:

* aspartate aminotransferase (AST) / alanine aminotransferase (ALT) greater than 5X upper limit of normal
* serum creatinine greater than 1.5X upper limit of normal
* total bilirubin greater than 1.5X upper limit of normal
4. be currently in jail, prison or any inpatient overnight facility as required by court of law or have pending legal action or other situation (e.g., unstable living arrangements) that, in the judgement of the site investigator, could prevent participation in the study or in any study activities;
5. be currently receiving methadone or naltrexone for the treatment of OUD;
6. be enrolled in or planning to enroll in treatment beyond the level 3.3 (Clinically Managed Population-Specific High-Intensity Residential Services) of the American Society of Addiction Medicine criteria; for level 3.3, the participant must have the ability to leave the facility unaccompanied by staff as needed;
7. be enrolled in or planning to enroll in: a) a trial testing medication for managing OUD during pregnancy; b) research testing an intervention for substance use disorder or NOWS in their infant unless they are willing to provide a release for the research records.
Minimum Eligible Age

18 Years

Maximum Eligible Age

41 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

The Emmes Company, LLC

INDUSTRY

Sponsor Role collaborator

T. John Winhusen, PhD

OTHER

Sponsor Role lead

Responsible Party

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T. John Winhusen, PhD

Professor; Vice Chair and Division Director of Addiction Sciences

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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T. John Winhusen, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Cincinnati

Locations

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Gateway Community Services

Jacksonville, Florida, United States

Site Status

Massachusetts General Hospital HOPE Clinic

Boston, Massachusetts, United States

Site Status

Boston Medical Center

Boston, Massachusetts, United States

Site Status

University of New Mexico Milagro Clinic

Albuquerque, New Mexico, United States

Site Status

University of Cincinnati Health Perinatal Addictions Program

Cincinnati, Ohio, United States

Site Status

CODA, Inc.

Portland, Oregon, United States

Site Status

Pregnancy Recovery Center at Magee-Womens Hospital of UPMC

Pittsburgh, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

University of Utah SUPeRAD Clinic

Salt Lake City, Utah, United States

Site Status

Addiction Recovery Services (ARS), Swedish Medical Center

Seattle, Washington, United States

Site Status

Marshall Health MARC Program

Huntington, West Virginia, United States

Site Status

Countries

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United States

References

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Cash E, Cochran G, Smid MC, Charles JE, Humiston G, Wei Y, Mauerman N, Carlston K, Broussard G, Sengpraseut B, Martin PR, Winhusen TJ. Overdose risk profiles in pregnancy: Latent class analysis of pregnant individuals with opioid use disorder. J Subst Use Addict Treat. 2025 Sep 25:209809. doi: 10.1016/j.josat.2025.209809. Online ahead of print.

Reference Type DERIVED
PMID: 41015387 (View on PubMed)

Winhusen TJ, Kropp F, Greenfield SF, Krans EE, Lewis D, Martin PR, Gordon AJ, Davies TH, Wachman EM, Douaihy A, Parker K, Xin X, Jalali A, Lofwall MR. Trauma Prevalence and Its Association With Health-related Quality of Life in Pregnant Persons With Opioid Use Disorder. J Addict Med. 2025 Jan-Feb 01;19(1):20-25. doi: 10.1097/ADM.0000000000001366. Epub 2024 Aug 6.

Reference Type DERIVED
PMID: 39105509 (View on PubMed)

Kropp FB, Smid MC, Lofwall MR, Wachman EM, Martin PR, Murphy SM, Wilder CM, Winhusen TJ. Collaborative care programs for pregnant and postpartum individuals with opioid use disorder: Organizational characteristics of sites participating in the NIDA CTN0080 MOMs study. J Subst Use Addict Treat. 2023 Jun;149:209030. doi: 10.1016/j.josat.2023.209030. Epub 2023 Apr 4.

Reference Type DERIVED
PMID: 37023858 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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UG1DA013732

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2019-0429-1

Identifier Type: -

Identifier Source: org_study_id

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